Apparatus for producing artificial respiration



May 11, 1937 B. c. H. sAHLlN 2,079,952 APPARATUS FOR PRODUCING ARTIFICIAL RESPIRATIN Filed Sept. 22, 1934 3 Sheets-Sheet May 1l, 1937. B. c. H. SAHLIN 2,079.952

V APPARATUS FOR PRODUCING ARTLFICIAL RESFIRATION y Filed Sept. 22, 1934 3 Sheets-Sheet 2 s sheets-sheet 5 May 1l, 1937. B. c. H. sAHLlN APPARATUS FOR PRODCING ARTIFICIAL RESPIRATION Filed sept. 22, 1954 Patented May 11, 1937 PATENT ortica APPARATUS FOR PRODUCENG ARTIFICIAL RESPIRATION Bo Carl Henrik Sahlin, Lund, Sweden l Application September 22, 1934, Serial No. 745,111

In Sweden September 27, 1933 s claims. `(cl. 12s-3o) This invention relates to apparatus for producing artificial respiration of that type in which a casing is used adapted to enclose a part of the body of thel patient but to leave uncovered the head, neck, limbs and the analand urogenitalparts. In the said casing rhythmical changes of pressure are eiected, so that the chest and abdomen of the patient are compressed and expanded alternately.

Apparatus of the said type generally have been comparatively complicated and consequently ex pensive but nevertheless usable only for persons of special limited sizes and besides the application of the apparatus was troublesome and timeconsuming. Besides, the analand urogenitalparts often were accessible only with difliculty, which, regarding patients, who mustbe treated for a long period, involved great inconveniences. Finally, suilicient regard has not been paid to the fact, that diierent positions of the patient during the treatment often are desired.

All the said disadvantages are removed through the present invention whichxelates to an apparatus which chieily is .characterized by a support for the back of the patient and a hood substantially in the shape of a reversed U or the like which by means of its shanks can straddle the said support and fit tightly to the same and which is provided with tightening cloths or the like tting to the body and the support.

Preferably, the said support is adjustable with regard to its Width, so that it may be adapted to CTI different sizes of body. Also the width of the hood is hereby adapted to different sizes of the bodies and besides there will always be a certain space between the sides of the body and the hood, which is of importance in order that the movements of the body resulting from the respiration may not be prevented in any way during the.

treatment.

'I'he invention also comprises some details', which are stated in the following description of a form of execution of the apparatus shown as an example in the accompanying drawings.

Fig. 1 is a -side View of the apparatus; a patient resting on his back is illustrated by dotted lines. Fig.2 is an end view of the apparatus partially in cross section on the line II-II in Fig. 1; some parts are shown in unsymmetrical positions. Fig. 3 shows in an end view and, on a greater scale, some details. Fig. 4 is a side view and Fig. 5 a lplan View of the same details. Fig. 6 is a section of some other details. Fig. '1 is a section on the line VII-VII of Fig. 6. Fig. 8 shows in end view a further detail. Fig. 9 shows,

in a side view, a driving unit. Fig. 10 is an end view of the same unit. In Figs. 9 and 10 a casing enclosing the unit is shown in section so that inner parts are visible. Fig. 11 shows a detail of the driving unit.

The apparatus is carried by a pillar I, to which a support 3 is pivoted at 2. The said support carries a frame work .4 which is swingable on the horizontal shaft 5 of the support but is normally held in adjusted position by a locking mechanism B which may be disengaged by means of a handle 1. Y The :frame work is turned or tilted laterally on the pin 2 by rotating a crank 8 on the shaft 5. For that purpose shaft 5 is screw-threaded so that the rotating of the shaft 5 in the one or the other direction results in the shaft being moved toward the right or left hand side Ithrough a die I0 journaled in the pillar I (Fig. 2), which evidently, eil'ects a tilting of frame work 4 laterally of pillar I. A plate I I, adapted to support the legs of the patient,.is swingably connected to the frame work 4. A second plate I2 is swingably connected to the frame work and adapted to serve as a support for the head of the patient. The said plates II and I2 are xed in adjusted position by easily manipulated locking mechanisms 'I3 and I4 respectively. Preferably, the plate II is provided with an adjustable purchase III for the feet of the patient, which purchase partially supports the -patient when the table II has been brought into a certain slanting position.

'Iwo slides I5 and I 6 (Fig. 2)- are provided in the top part of the frame work, which slides may be moved toward and from each other transversely of the apparatus and are adapted to form a mounting for a rest or support for the back of the patient. The said support together with the plates II and I2 constitute an equivalence to an adjustable table for operations.

Preferably, the said support' consists of airtight rubber-cloth stretched over two longitudinal supporting rods I8 of a comparatively soft material. lThe said rods are fixed in a suitable manner in the slides I 5 and I6, which are constructed as frames or the like and are movable in guides I9 (Figs. 3 5) provided in the frame work Il. Ropes or the like are xed to the longitudinal edges of the rubber-cloth and pass round rollers the frame-work 4 and provided with right handed screw-threads for the dies 23 of the one slide and left-handed screw-threads for the dies of the other slide. Sprocket wheels 25 are fixed on the shafts 24 and' a chain-26 is placed round the sprocket wheels so that while one of the shafts is rotated this results in the second shaft also being positively rotated. The rotating may be eected by the crank 8 mentioned above, which for this purpose is dismounted from the shaft 5 and mounted on one of the shafts 24 at the one or the other side of the table. As

`the shafts are rotated in the one or the other direction the said: dies, evidently, are moved either toward or from each other on the said shafts, provided with right-handed and lefthanded threads, which results in the slides I5 and I6 being moved towards or from each other. During this movement the rubber-cloth Il always is held in a stretched condition owing to the provision Aof the ropes 20.

'I'he rest or support constituted by the cloth I'I and the rods I8 is straddled by a reversed substantially U-shaped hood. Preferably the said hood is made of springy sheet metal 21, to the edges of which are fixed, in a suitable manner, tightening cloths 28. The shanks of the hood, which extend through the slides, are adapted to be forced tightly against the cloth I1 at those places where it is placed round the supporting rods I8. For the said forcing of the shanks against the cloth bell crank levers 29 v'or the like l'are used which are mounted in a turnable and in a slidablemanner on rods 30 carried by the slides I5 and I6 (Fig. 8). The said levers '29 are connected by a girdle 3| which is laid over the hood and may be tightened partly for forcing the shanks of the hood downwards, partly for turning the levers 29,.so that their inner arms are caused to force the shanks of the hood against the rods I8. As already stated, the levers 29 are slidably mounted on the rods 30. This is of importance with regard to the proper mounting of the hood longitudinally of the table. The said girdle 3| may be suitably guided relatively to the hood.

For causing the tightening cloths 28 to fit closely to the body of the patient as well as to the rubber-cloth I1, jam-members (Figs. 3-7) are provided, which according to. the illustrated form of execution consist of tongue shaped pieces 33 or the like provided with'a handle 32. The'said jam-members are carried by blocks 34, which are slidably mounted on the rods 30 mentioned above. Blocks 34 are provided with openings for the shanks of a recurved pin 35, the one shank of which extends through a slot 35 in the jam-member 33. A'nut 3 1 is in screwthreaded engagement with the shank just mentioned and a die 38 is located under the nut. A handle 39 is pivoted to the said die 38 and bears against the jam-member 33 byv means of an eccentric 40 or the like. Jam-member 33 rests upon a clutch member 4| guided by the slot 36 and provided with teeth 42, adapted to engage corresponding teeth provided in the block 34. A spring 43 is located between the clutch member and the block which spring tends to disengage' the teeth. The curve shaped part of the pin embraces a rod 44, which is parallel to the rod.30.

As the described jam-devices should be usedaovaasa the engagement of the teeth being thereby interrupted. The jamming engagement of the pin with the rod 44 is also reduced in some degree. Block 34 may now be moved along the rod 30 so that the jam-member 33 is adjusted into a suitable position. swung by means of the handle 32 inwards against the tightening cloth 28 substantially in the manner shown in Figs. 3 and 5, so that it is forced inwards against the body of the patient and the tightening cloth fits closely to same and partially to the rubber-cloth I1. Handle 39 is then swung` downwards into the horizontal position, so that the jam-member is forced downwards and the tightening operation is completed. The teeth of the clutch members now again The jam-member is then engage each other and the curve shaped partl g ple manner and involves besides the advantagev that the jamming positions may be adapted with regard to size of the body of the patient and vto other different conditions.A

After the patient has been placed on the table with his back resting on the same and the members of the table have been brought into the desired positions one makes certain that the supporting rods I8 are located somewhat outside the sides of the patient, which easily isA effected r by rotating one of the shafts 24 in the one or other direction by means of the crank 8 so that the slides I5 and I6 are moved-towards or from each other. The U-shaped hood is then placed in proper position over the sheet and the abdomen of the patient, so-that it straddles with its shanks the patient as well as the support. It must be observed, that there will be aI certain distance between the sides of the patient and the shanks of the hood, so that the chest of the patient may freely expand in all directions without being prevented in any way from such movements as correspond to the maximum breathing movements. The gaining of the said distance is rendered possible by the support being adjustable, so that the rods I8 to which the shanks of the hood are jammed always may be adjusted into such positions that they are located outside the sides of the patient. As the yhood has been placed substantially in the desired position the girdle 3| is tightened which results asv before stated in the hood being somewhat lowered and the bell crank levers 29 forcing the shanks of the hood inwards against the supporting rods I8, so that the shanks t closely to the cloth placed on the said rods. The jam? devices 33-43 described above are then pushed on the rods 30 and 44 into suitable positions and the jam-members 33 are swung inwards against the tightening cloths 28 in the manner described above, so that the cloths fit closely to the body of the patient, whereupon the jammembers are locked. 'I'he treatment may then' commence and is effected substantially in known manner by changes of. the pressure in the in- .terior of the hood being produced. The said changes of the pressure are transmitted throughA a hose 45 connected to the hood (Fig. 1). For effecting the changes of pressure preferably a separate, easily movable unit'isl used. Figs. 9 and 10 show a form of execution of the same. The said unit comprises a casing 50, which is movable on wheels and in which are mounted an electric motor and a pump 52 with piston. The said motor which is controlled outside the casing by means of a hand wheel 53, rotates by means of worm gear 54 a fly wheel 55 which is connected to the piston 51 of the said pump by a rod' 56. For the altering of the stroke of the piston a slot, 58 is provided in the ily-wheel 55, in which the connecting pin of the said rod 56 may be locked in adjusted position. The pump cylinder 52 communicates through a pipe 59 and the hose 45 mentioned above with the hood to which, consequently, rhythmical changes of pressure are transmitted as a result of the motion of the piston 5 2. A branch B0 of the pipe 59 may be put into a controllable communication with the'atmospheric air by a cock 6I or the like, so that a rapid and convenient controlling of the changes ofpressure in the hood is rendered possible. As a guard against the creation of non-perrnissible variations of the pressure, the

pump cylinder may be provided with two valves 52, one of which is opened for. the admission of air into the cylinder if a too great vacuum is created in the same and the other valve is openedv for the discharging of air from the cylinder if a too high pressure should arise. Only one of the valves is shown in the drawings. For the indicating of the changes of the pressure in the interior of the hood a manometer preferably is provided which through a separate conduit communicates directly with the interior of the hood. The separate conduit may be connected to the hood simultaneously with the hose 45.

Owing to the fact that the pump sometimes must operate during very long periods an effective lubricating of the same is of importance. For that purpose a ring-shaped chamber 63 is provided in the lower part of the pump cylinder, which chamber is partially charged with a lubricant, into which lubricant a ring-shaped `flange 64 of the piston 51 is dipped at each descending movement. The piston is thereby lubricated auz tomatically and, besides, lubricant is dragged upward and passes downwards to the bearing of the connecting rod for instance through substantially radial grooves or channels. For preventing lubricant from splashing outward at the lower end of the cylinder, as the flange 64 of the piston is dipped into the lubricant, special protection means are provided.

Although the `hood straddling the rest or support and theadjustability of the rest with regard to its width render possible -a convenient adjusting of the apparatus to different sizes of the bodies within comparatively wide limits, two

hoods of different sizes at least preferably are used. Besides, the hood may be composed of parts which may be moved toward and from each other, so that the dimensions of the hood may be altered.

A certain leakage even of a slight amount at the different joints of the hood may scarcely be obviated, but practically it may be neglected. The leakage on the other hand effects a certain draught which cools the patient and for the o bviating of this drawback the air delivered by the pump may be heated in va suitable manner.

The construction of the apparatus may, evidently, be varied without exceeding the limits of the invention which consequently is not confined to'comprise the described form of execution. For instance all setting mcchanismj\ may becombined with or coupled to a controlling detightening places.

vice common to the same, which renders possible the substantially simultaneously setting at all The said controlling mechanism may, if desired, be connected also with the supporting rods. Any othersuitable device than the piston pump may be used for effecting the' changes of the pressure and so on.

I claim:

l. In an apparatus for producing artificial respiration with the aid of a casing which is adapted to enclose a part of the body of the patient but to leave uncovered the head, neck, limbs and the analand urogenital-parts and in the interior of which rhythmical changes of the pressure are elected, for instance by means of a pump, the combination of a support for the back of the patient, which support is adjustable with respect to its width, a substantially U-shaped hood, which by means of resilient Shanks can straddle the said support and fit tightly to the` to leave uncovered the head, neck, limbs and the analand urogen'ital-parts and in the interior of which rhythmical changes of the pressure are effected, for instance by means of ay pump, the combination of a support for the back of the patient, which support isadjustable with respect to its width and consists ofa rubber-cloth, which is stretched over'two supporting rods,'extending longitudinally of the apparatus and mounted on two-slides which are slidable toward and from each other transversely of the table of the apparatus, a substantially U-shaped hood, which by means of resilient Shanks can `straddle the said support and t tightly to thesame, independent of the adjusted width of the support and tightening cloths adapted to t closely to the body and to the .said support.

3. In an apparatus for producing artificial respiration with the aid of acaslng, which is adapted to enclose a part of the body of the patient but to leave uncovered the head, neck, limbs and the analand urogenital-parts and in the interior Vof which rhythmical changesV of the pressure are effected, for instance by means of a pump, the combination of a support for the back of the patient, which support is adjustable with respect to its width and -consists of a rubber-cloth, to each longitudinal edge of which is fixed one end of a rope which returns over a roller carried by a slide, said rope being fixed at its other end to the table of the apparatus so that the cloth always may be held in stretched condition, independently of the width of the support, a substantially U-shaped hood which by' means of resilient shanks can straddle the said support and fit tightly to the same, independent of the adjustedwidth of the support, and tightening cloths adapted to t closely'to the body and to the said.

support.

4. An apparatus as claimed in claim l, characterized by the fact, that the jam-devices are adjustable longitudinally of the' table, so that they may be mounted into suitable positions with relation to the hood mounted in proper position.

5. -An apparatus as claimed in claim 1, characterized by the fact that the Jam-devices comprise eccentrics, which are rotatably mounted on rods carried by the slides and may be connected to one another .by means of a girdle placed over 15 the tightening cloths of the hood against the support, the tightening cloths being thereby forced against the body of the patient and caused to tighten to the body of the patient.

7. An apparatus as claimed in claim 1, characterized by the fact that with the slides motion transmitting means are combined, which may be acted upon at both sides of the table, so that the adjusting of the width of the support may be effected at any side of the table.

8. An apparatus as claimed in claim 1, char acterized by the fact that the motion transmitting devices of the slides consist f screwspindles which are journaled in the table of the apparatus and provided with right-handed and left-handed screw-threads and screwed into corresponding dies fixed to the slides respectively so that the slides are moved towards each other, as the spindles are rotated in one direction and away from each other as the spindles are rotated in the opposite direction.

BO CARL HENRIK SAHLIN. 

